Lee W Bradshaw, APRN

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

6242996-4405 Issued in UT

Practice address

3903 Harrison Blvd
#300
Ogden, UT 84403-8440

Phone

(801) 387-4930

Fax

(801) 387-9470

NPI assigned

Jun 22, 2005

Last updated

Jul 12, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ihc Health Services Inc

  dba IMED Physicians Billing

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1629260880
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Ihc Health Services Inc

  dba Hillcrest Pediatrics

  • Pediatrics Physician
  • Murray, UT
  • NPI 1659569358
  NPD
• Ihc Health Services Inc

  dba Utah Valley Hospital Physicians

  • Multi-Specialty Clinic/Center
  • Provo, UT
  • NPI 1669422101
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Joel a. Holiner, MD PA

  dba Holiner Psychiatric Group

  • Psychiatric/Mental Health Nurse Practitioner
  • Dallas, TX
  • NPI 1346259645
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1588660773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-387-5600",
            "fax_number": "801-475-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 HARRISON BLVD",
            "address_2": "#300",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844038440",
            "telephone_number": "801-387-4930",
            "fax_number": "801-387-9470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "LEE",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "UT",
            "license": "6242996-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lee.bradshaw@imail.org",
            "affiliation": "N",
            "address_1": "3903 Harrison Blvd",
            "address_2": "#300",
            "city": "OGDEN",
            "state": "UT",
            "country_code": "US",
            "postal_code": "844038440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brooke Boyd
• Kimberly A Boyer, PA-C
• Tobie Boyko
• Kaydee Boyle, RN
• Sandra Bradbury, M.S. CF-SLP
• Poppy Anne Bradshaw
• Ann B Brady, COTA
• Jennifer L Braegger, BSN
• Brain Behavior Associates, P.C.
• Shelley Ann Branch

• Psychiatric/Mental Health Clinical Nurse Specialist in Ogden, UT
• Providers in Ogden, UT by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.